Acute rupture of distal biceps: Repair using a single anterior approach and cortical anchoring device
DOI:
https://doi.org/10.31053/1853.0605.v78.n1.28122Keywords:
tendon rupture, distal biceps, surgical repair, reinsertionAbstract
Background: Rupture of the distal tendon of the biceps is a pathology with an increasing incidence, which can cause important functional alterations. When the rupture is complete and the patient is active, surgical treatment is of choice.
Material and method: 47-year-old man with sudden and intense pain in the left antecubital fossa while lifting weight. On examination, impotence for flexion and active supination of the left arm with loss of the biceps silhouette. Ultrasonography confirms the diagnosis of complete rupture of the distal biceps tendon. Surgical treatment was decided, performing a single anterior approach and reinserting the tendon in its radial footprint with the help of a cortical anchorage device.
Results: At 12 months, the patient presented flexo-extension and complete prone supination, without encountering difficulties in carrying out the activities of his daily and work life, with a score of 100 points in the Mayo Elbow Performance Score (MEPS).
Conclusion: Rupture of the distal biceps is a typical injury in active patients with an increasing incidence. Although there have been no significant differences between the different repair options, in our experience the use of cortical anchorage devices with a single anterior approach provides very satisfactory results.
Downloads
References
Rantanen J, Orava S. Rupture of the distal biceps tendon. A report of 19 patients treated with anatomic reinsertion, and a meta-analysis of 147 cases found in the literature. Am J Sports Med. 1999 Mar-Apr;27(2):128-32. doi: 10.1177/03635465990270020201.
Safran MR, Graham SM. Distal biceps tendon ruptures: incidence, demographics, and the effect of smoking. Clin Orthop Relat Res. 2002 Nov;(404):275-83.
Holt J, Preston G, Heindel K, Preston H, Hill G. Diagnosis and Management Strategies for Distal Biceps Rupture. Orthopedics. 2019 Nov 1;42(6):e492-e501. doi: 10.3928/01477447-20190723-05.
Pallante GD, O'Driscoll SW. Return of an Intact Hook Test Result: Clinical Assessment of Biceps Tendon Integrity After Surgical Repair. Orthop J Sports Med. 2019 Feb 25;7(2):2325967119827311. doi: 10.1177/2325967119827311.
Alentorn-Geli E, Assenmacher AT, Sánchez-Sotelo J. Distal biceps tendon injuries: A clinically relevant current concepts review. EFORT Open Rev. 2017 Mar 13;1(9):316-324. doi: 10.1302/2058-5241.1.000053.
García Rodríguez C, García-Polín López C, Del Olmo Hernández T, Moros Marco S, Jacobo Edo O, Ávila Lafuente JL. Distal biceps tendon rupture: diagnostic strength of ultrasonography and magnetic resonance. Rev Esp Cir Ortop Traumatol. 2020 Mar-Apr;64(2):77-82. English, Spanish. doi: 10.1016/j.recot.2019.11.004.
Barco Laakso R. Reinserción del tendón distal del bíceps. Rev Esp Artrosc Cir Articul 2018; 25(2):173-83. doi: 10.24129/j.reaca.25263.fs1712060.
Cerciello S, Visonà E, Corona K, Ribeiro Filho PR, Carbone S. The Treatment of Distal Biceps Ruptures: An Overview. Joints. 2019 Oct 11;6(4):228-231. doi: 10.1055/s-0039-1697615.
Srinivasan RC, Pederson WC, Morrey BF. Distal Biceps Tendon Repair and Reconstruction. J Hand Surg Am. 2020 Jan;45(1):48-56. doi: 10.1016/j.jhsa.2019.09.014.
Amarasooriya M, Bain GI, Roper T, Bryant K, Iqbal K, Phadnis J. Complications After Distal Biceps Tendon Repair: A Systematic Review. Am J Sports Med. 2020 Oct;48(12):3103-3111. doi: 10.1177/0363546519899933.
Stockton DJ, Tobias G, Pike JM, Daneshvar P, Goetz TJ. Supination torque following single- versus double-incision repair of acute distal biceps tendon ruptures. J Shoulder Elbow Surg. 2019 Dec;28(12):2371-2378. doi: 10.1016/j.jse.2019.07.041.
Capomassi MÁ, Gardenal RM, Slullitel M, Suárez E, Benedetto I. Rotura del bíceps distal. Evaluación de resultados con técnica de doble fijación. Rev Asoc Argent Ortop Traumatol 2013;78(04):171–79. doi: 10.15417/241.
Capomassi MA, Vélez MA, Gardenal RM. Doble fijación para la rotura de bíceps distal: Descripción de la técnica y evaluación de resultados. Rev Iberam Cir Mano 2017;45(01):16-23. doi: 10.1055/s-0037-1602793
Reichert P, Królikowska A, Kentel M, Witkowski J, Gnus J, Satora W, Czamara A. A comparative clinical and functional assessment of cortical button versus suture anchor in distal biceps brachii tendon repair. J Orthop Sci. 2019 Jan;24(1):103-108. doi: 10.1016/j.jos.2018.08.007.
Rubinger L, Solow M, Johal H, Al-Asiri J. Return to work following a distal biceps repair: a systematic review of the literature. J Shoulder Elbow Surg. 2020 May;29(5):1002-1009. doi: 10.1016/j.jse.2019.12.006.
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Universidad Nacional de Córdoba
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The Faculty of Medical Sciences Journal (RFCM) subscribes to the Open Access policy and does not charge authors fees for publishing, nor does it charge readers fees for accessing published articles (APC).
